CPT 93295 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | • Medicine Services and Procedures • Cardiovascular Procedures |
| Common Place of Service | • 11 - Office • 22 - On Campus Outpatient Hospital • 19 - Off Campus Outpatient Hospital |
| Common Modifiers | • None • 59 - Distinct Procedural Service • 26 - Professional component |
| Complexity Level | Low |
National average reimbursement for CPT 93295 by major payers:
$58.97
$67.07
$68.93
$86.11
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 93295 | ||||||
United | 93295 | $112.66 | 1194049676 - TRACY BINIUS | 205996177 | IL | Psychiatry Physician (2084P0800X) |
United | 93295 | $108.93 | 1194149104 - ADVENTIST HEALTH PARTNERS, INC, SALT CREEK THERAPY CENTER | 800607953 | IL | Psychiatry Physician (2084P0800X) |
United | 93295 | $75.87 | 1962664789 - JAMIE EVANS | 910844563 | IL | Psychiatry Physician (2084P0800X) |
United | 93295 | $169.27 | 1669524369 - JENNIFER KURTH | 205734385 | IL | Psychiatry Physician (2084P0800X) |
United | 93295 | $84.33 | 1699752394 - DAVID LOTT | 581672987 - (IL) EDWARD HEALTH VENTURES | IL | Psychiatry Physician (2084P0800X) |
United | 93295 | $75.87 | 1376063370 - ABBY FREDRICKSON | 910844563 | IL | Psychiatry Physician (2084P0800X) |
United | 93295 | $73.88 | 1174859284 - MATTHEW NIEDZWIECKI | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | RI | Psychiatry Physician (2084P0800X) |
United | 93295 | $76.59 | 1760412621 - RHONDA LAMPEN | 811324691 | CA | Psychiatry Physician (2084P0800X) |
United | 93295 | $96.63 | 1164410502 - ALAN FELTHOUS | 430654872 - ST LOUIS UNIVERSITY | IL | Psychiatry Physician (2084P0800X) |
United | 93295 | $150.13 | 1659732584 - JOANNA GARCIA PIERCE | 363279680 - (IL) PEDIATRIC FACULTY FOUNDATION IN | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 93295 | $73.88 | 1548279870 - VINOD ALLURI | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | TX | Psychiatry Physician (2084P0800X) |
United | 93295 | $150.13 | 1578957676 - LAURA VERNON | 363279680 - (IL) PEDIATRIC FACULTY FOUNDATION IN | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 93295 | $150.13 | 1689010373 - EWA BIEBER | 364187449 | IL | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 93295 | $150.13 | 1205213261 - TAMAR CACERES | 363279680 - (IL) PEDIATRIC FACULTY FOUNDATION IN | IL | Neurodevelopmental Disabilities Physician (2084P0005X) |
United | 93295 | $65.19 | 1437298361 - ALIYA HAFEEZ | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | Psychiatry Physician (2084P0800X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 93295 vs. Other Cardiovascular Procedures Codes
The CPT 93295 code is part of the Medicine Services and Procedures services used for Cardiovascular Procedures. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 93295 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 93293-CPT | Low | Transtelephonic Rhythm Strip Pacemaker Evaluation(S) Single Dual Or Multiple Lead Pacemaker System Includes Recording With And Without Magnet Application With Analysis Review And Report(S) By A Physician Or Other Qualified Health Care Professional Up To 90 Days (Revised 01/01/13) |
| 93294-CPT | Low | Interrogation Device Evaluation(S) (Remote) Up To90 Days; Single Dual Or Multiple Lead Pacemaker System Or Leadless Pacemaker System With Interim Analysis Review(S) And And Report(S) By A Physician Or Other Qualified Health Care Professional (Desc Rvsd 1/1/19) |
| 93295-CPT | Low | Interrogation Device Evaluation(S) (Remote) Up To90 Days; Single Dual Or Multiple Lead Implantable Defibrillator System With Interim Analysis Review(S) And Report(S) By A Physician Or Other Qualified Health Care Professional (Revised 01/01/15) |
| 93296-CPT | Low | Interrogation Device Evaluation(S)(Remote) Up To 90 Days; Single Dual Or Multiple Lead Pacemaker System Or Leadless Pacemaker System Or Implant- Able Defibrillator System Remote Data Acuisi- Tion(S) Receipt Of Transmissions And Technician Review Technical Support And Distribution Of Results (Desc Rvsd 1/1/19) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 93295. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 93295 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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